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Published in: BMC Neurology 1/2014

Open Access 01-12-2014 | Research article

Views of people with traumatic spinal cord injury about the components of self-management programs and program delivery: a Canadian pilot study

Authors: Sarah EP Munce, Michael G Fehlings, Sharon E Straus, Natalia Nugaeva, Eunice Jang, Fiona Webster, Susan B Jaglal

Published in: BMC Neurology | Issue 1/2014

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Abstract

Background

Given the increasing emphasis on the community management of spinal cord injury (SCI), strategies that could be developed and implemented in order to empower and engage individuals with SCI in promoting their health and minimizing the risk of health conditions are required. A self-management program could be one approach to address these complex needs, including secondary complications. Thus, the objective of this study was to determine the importance attributed to the components of a self-management program by individuals with traumatic SCI and explore their views/opinions about the delivery of such a program.

Methods

Individuals with SCI were recruited by email via the Rick Hansen Institute (Vancouver, British Columbia, Canada) as well as an outpatient hospital spinal clinic. Data were collected by self-report using an on-line survey.

Results

The final sample size was 99 individuals with traumatic SCI. The components of a self-management program that were rated as “very important” by the greatest proportion of participants included: exercise (n= 53; 53.5%), nutrition (n= 51; 51.5%), pain management (n= 44; 44.4%), information/education on aging with a SCI (n= 42; 42.4%), communicating with health care professionals (n= 40; 40.4%), problem solving (n= 40; 40.4%), transitioning from rehabilitation to the community (n= 40; 40.4%), and confidence (n= 40; 40.4%). Overall, 74.7% (n= 74) of the sample rated the overall importance of the development of a self-management program for individuals with traumatic SCI as “very important” or “important”. Almost 40% (n= 39) of the sample indicated that an internet-based self-management program would be the best delivery format. The highest proportion of participants indicated that the program should have individuals of a similar level of injury (n= 74; 74.7%); having individuals of a similar age (n= 40; 40.4%) was also noted. Over one-quarter of the sample (n= 24) had a depression score consistent with significant symptoms of depression.

Conclusions

Future research is needed to further evaluate how the views of people with traumatic SCI change over time. Our findings could be used to develop and pilot test a self-management program for individuals with traumatic SCI.
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Literature
1.
go back to reference Chen D, Apple DF, Hudson LM, Bode R: Medical complications during acute rehabilitation following spinal cord injury-current experience of the model systems. Arch Phys Med Rehabil. 1999, 80: 1397-1401. 10.1016/S0003-9993(99)90250-2.CrossRefPubMed Chen D, Apple DF, Hudson LM, Bode R: Medical complications during acute rehabilitation following spinal cord injury-current experience of the model systems. Arch Phys Med Rehabil. 1999, 80: 1397-1401. 10.1016/S0003-9993(99)90250-2.CrossRefPubMed
2.
go back to reference McColl MA, Aiken A, McColl A, Sakakibara B, Smith K: Primary care of people with spinal cord injury. Can Fam Physician. 2012, 58: 1207-1216.PubMedPubMedCentral McColl MA, Aiken A, McColl A, Sakakibara B, Smith K: Primary care of people with spinal cord injury. Can Fam Physician. 2012, 58: 1207-1216.PubMedPubMedCentral
3.
go back to reference Jones ML, Evans RW: Outcomes in a managed care environment. Top Spinal Cord Injury Rehabil. 1998, 3: 61-73. Jones ML, Evans RW: Outcomes in a managed care environment. Top Spinal Cord Injury Rehabil. 1998, 3: 61-73.
4.
go back to reference Jaglal SB, Munce SEP, Guilcher SJT, Couris CM, Fung K, Craven BC, Verrier M: Health system factors associated with rehosptialisations after traumatic spinal cord injury: a population-based study. Spinal Cord. 2009, 47: 604-609. 10.1038/sc.2009.9.CrossRefPubMed Jaglal SB, Munce SEP, Guilcher SJT, Couris CM, Fung K, Craven BC, Verrier M: Health system factors associated with rehosptialisations after traumatic spinal cord injury: a population-based study. Spinal Cord. 2009, 47: 604-609. 10.1038/sc.2009.9.CrossRefPubMed
5.
go back to reference Munce SEP, Guilcher SJT, Couris CM, Fung K, Craven BC, Verrier M, Jaglal SB: Physician utilization among adults with traumatic spinal cord injury in Ontario: a population-based study. Spinal Cord. 2009, 47: 470-476. 10.1038/sc.2008.173.CrossRefPubMed Munce SEP, Guilcher SJT, Couris CM, Fung K, Craven BC, Verrier M, Jaglal SB: Physician utilization among adults with traumatic spinal cord injury in Ontario: a population-based study. Spinal Cord. 2009, 47: 470-476. 10.1038/sc.2008.173.CrossRefPubMed
6.
go back to reference Vaidyanathan S, Soni BM, Gopalan L, Sett P, Watt JW, Singh G, Bingley J, Mansour P, Krishnan KR, Oo T: A review of the readmissions of patients with tetraplegia to the Regional Spinal Injuries Centre, Southport, United Kingdom, between January 1994 and December 1995. Spinal Cord. 1998, 36: 838-846. 10.1038/sj.sc.3100629.CrossRefPubMed Vaidyanathan S, Soni BM, Gopalan L, Sett P, Watt JW, Singh G, Bingley J, Mansour P, Krishnan KR, Oo T: A review of the readmissions of patients with tetraplegia to the Regional Spinal Injuries Centre, Southport, United Kingdom, between January 1994 and December 1995. Spinal Cord. 1998, 36: 838-846. 10.1038/sj.sc.3100629.CrossRefPubMed
7.
go back to reference Kroll T, Neri MT, Ho P-S: Secondary conditions in spinal cord injury: results from a perspective survey. Disabil Rehabil. 2007, 29: 1229-1237. 10.1080/09638280600950603.CrossRefPubMed Kroll T, Neri MT, Ho P-S: Secondary conditions in spinal cord injury: results from a perspective survey. Disabil Rehabil. 2007, 29: 1229-1237. 10.1080/09638280600950603.CrossRefPubMed
8.
go back to reference Hirsche RC, Williams B, Jones A, Manns P: Chronic disease self-management for individuals with stroke, multiple sclerosis and spinal cord injury. Disabil Rehabil. 2011, 33: 1136-1146. 10.3109/09638288.2010.523103.CrossRefPubMed Hirsche RC, Williams B, Jones A, Manns P: Chronic disease self-management for individuals with stroke, multiple sclerosis and spinal cord injury. Disabil Rehabil. 2011, 33: 1136-1146. 10.3109/09638288.2010.523103.CrossRefPubMed
9.
go back to reference Lorig KR, Sobel D, Stewart A, Brown B, Bandura A, Ritter P, Gonzalez V, Laurent D, Holman H: Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care. 1999, 37: 5-14. 10.1097/00005650-199901000-00003.CrossRefPubMed Lorig KR, Sobel D, Stewart A, Brown B, Bandura A, Ritter P, Gonzalez V, Laurent D, Holman H: Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care. 1999, 37: 5-14. 10.1097/00005650-199901000-00003.CrossRefPubMed
10.
go back to reference Lorig KR, Ritter P, Stewart AL, Sobel DS, Brown BW, Bandura A, Gonzalez VM, Laurent DD, Holman HR: Chronic disease self-management program: 2-year health status and health care utilization outcomes. Med Care. 2001, 39: 1217-1223. 10.1097/00005650-200111000-00008.CrossRefPubMed Lorig KR, Ritter P, Stewart AL, Sobel DS, Brown BW, Bandura A, Gonzalez VM, Laurent DD, Holman HR: Chronic disease self-management program: 2-year health status and health care utilization outcomes. Med Care. 2001, 39: 1217-1223. 10.1097/00005650-200111000-00008.CrossRefPubMed
11.
go back to reference Bandura A: Health promotion by social cognitive means. Health Educ Behav. 2004, 31: 143-164. 10.1177/1090198104263660.CrossRefPubMed Bandura A: Health promotion by social cognitive means. Health Educ Behav. 2004, 31: 143-164. 10.1177/1090198104263660.CrossRefPubMed
12.
go back to reference Lorig K, Ritter PL, Plant K: A disease-specific self-help program compared with a generalized chronic disease self-help program for arthritis patients. Arthritis Rheum. 2005, 53: 950-957. 10.1002/art.21604.CrossRefPubMed Lorig K, Ritter PL, Plant K: A disease-specific self-help program compared with a generalized chronic disease self-help program for arthritis patients. Arthritis Rheum. 2005, 53: 950-957. 10.1002/art.21604.CrossRefPubMed
13.
go back to reference Taylor DM, Stone SD, Huijbregts MP: Remote participants’ experiences with a group-based stroke self-management program using videoconference technology. Rural Remote Health. 2012, 12: 1947-PubMed Taylor DM, Stone SD, Huijbregts MP: Remote participants’ experiences with a group-based stroke self-management program using videoconference technology. Rural Remote Health. 2012, 12: 1947-PubMed
14.
go back to reference Munce SEP, Webster F, Fehlings MG, Straus SE, Jang E, Jaglal SB: Perceived facilitators and barriers to self-management in individuals with traumatic spinal cord injury: a qualitative descriptive study. BMC Neurol. 2014, 14: 48-10.1186/1471-2377-14-48.CrossRefPubMedPubMedCentral Munce SEP, Webster F, Fehlings MG, Straus SE, Jang E, Jaglal SB: Perceived facilitators and barriers to self-management in individuals with traumatic spinal cord injury: a qualitative descriptive study. BMC Neurol. 2014, 14: 48-10.1186/1471-2377-14-48.CrossRefPubMedPubMedCentral
16.
go back to reference Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983, 67: 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRefPubMed Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983, 67: 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRefPubMed
17.
go back to reference Hibbard JH, Stockard J, Mahoney ER, Tusler M: Development of the patient activation measure: conceptualizing and measuring activation in patient and consumers. Health Serv Res. 2004, 39: 1005-1026. 10.1111/j.1475-6773.2004.00269.x.CrossRefPubMedPubMedCentral Hibbard JH, Stockard J, Mahoney ER, Tusler M: Development of the patient activation measure: conceptualizing and measuring activation in patient and consumers. Health Serv Res. 2004, 39: 1005-1026. 10.1111/j.1475-6773.2004.00269.x.CrossRefPubMedPubMedCentral
18.
go back to reference Hibbard JH, Mahoney E, Stockard J, Tusler M: Development and testing of a short form of the patient activation measure (PAM). Health Serv Res. 2005, 40: 1918-1930. 10.1111/j.1475-6773.2005.00438.x.CrossRefPubMedPubMedCentral Hibbard JH, Mahoney E, Stockard J, Tusler M: Development and testing of a short form of the patient activation measure (PAM). Health Serv Res. 2005, 40: 1918-1930. 10.1111/j.1475-6773.2005.00438.x.CrossRefPubMedPubMedCentral
19.
go back to reference Middleton JW, Tate RL, Geraghty TJ: Self-efficacy and spinal cord injury: psychometric properties of a new scale. Rehabil Psychol. 2003, 48: 281-288. 10.1037/0090-5550.48.4.281.CrossRef Middleton JW, Tate RL, Geraghty TJ: Self-efficacy and spinal cord injury: psychometric properties of a new scale. Rehabil Psychol. 2003, 48: 281-288. 10.1037/0090-5550.48.4.281.CrossRef
20.
go back to reference Pearlin LI, Schooler C: The structure of coping. J Health Soc Behav. 1978, 19: 2-21. 10.2307/2136319.CrossRefPubMed Pearlin LI, Schooler C: The structure of coping. J Health Soc Behav. 1978, 19: 2-21. 10.2307/2136319.CrossRefPubMed
21.
go back to reference Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res. 2002, 52: 69-77. 10.1016/S0022-3999(01)00296-3.CrossRefPubMed Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res. 2002, 52: 69-77. 10.1016/S0022-3999(01)00296-3.CrossRefPubMed
22.
go back to reference Barlow JH, Turner AP, Edwards R, Gilchrist M: A randomised controlled trial of lay-led self-management for people with multiple sclerosis. Patient Educ Couns. 2009, 77: 81-89. 10.1016/j.pec.2009.02.009.CrossRefPubMed Barlow JH, Turner AP, Edwards R, Gilchrist M: A randomised controlled trial of lay-led self-management for people with multiple sclerosis. Patient Educ Couns. 2009, 77: 81-89. 10.1016/j.pec.2009.02.009.CrossRefPubMed
23.
go back to reference Hibbard JH, Tusler M: Accessing activation stage and employing a “next steps” approach to supporting patient self-management. J Ambul Care Manage. 2007, 30: 2-8. 10.1097/00004479-200701000-00002.CrossRefPubMed Hibbard JH, Tusler M: Accessing activation stage and employing a “next steps” approach to supporting patient self-management. J Ambul Care Manage. 2007, 30: 2-8. 10.1097/00004479-200701000-00002.CrossRefPubMed
24.
go back to reference Mosen D, Schmittdiel J, Hibbard JH, Sobel D, Remmers C, Bellows J: Is patient activation associated with outcomes of care for adults with chronic conditions?. J Ambul Care Manage. 2007, 30: 21-29. 10.1097/00004479-200701000-00005.CrossRefPubMed Mosen D, Schmittdiel J, Hibbard JH, Sobel D, Remmers C, Bellows J: Is patient activation associated with outcomes of care for adults with chronic conditions?. J Ambul Care Manage. 2007, 30: 21-29. 10.1097/00004479-200701000-00005.CrossRefPubMed
25.
go back to reference SPSS Corp: Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp SPSS Corp: Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp
26.
go back to reference Craig A, Tran Y, Middleton J: Psychological morbidity and spinal cord injury: a systematic review. Spinal Cord. 2009, 47: 108-114. 10.1038/sc.2008.115.CrossRefPubMed Craig A, Tran Y, Middleton J: Psychological morbidity and spinal cord injury: a systematic review. Spinal Cord. 2009, 47: 108-114. 10.1038/sc.2008.115.CrossRefPubMed
27.
go back to reference Post MW, van Leeuwen CM: Psychosocial issues in spinal cord injury: a review. Spinal Cord. 2012, 50: 382-389. 10.1038/sc.2011.182.CrossRefPubMed Post MW, van Leeuwen CM: Psychosocial issues in spinal cord injury: a review. Spinal Cord. 2012, 50: 382-389. 10.1038/sc.2011.182.CrossRefPubMed
28.
go back to reference Kennedy P, Rogers BA: Anxiety and depression after spinal cord injury: a longitudinal analysis. Arch Phys Med Rehabil. 2000, 81: 932-937. 10.1053/apmr.2000.5580.CrossRefPubMed Kennedy P, Rogers BA: Anxiety and depression after spinal cord injury: a longitudinal analysis. Arch Phys Med Rehabil. 2000, 81: 932-937. 10.1053/apmr.2000.5580.CrossRefPubMed
29.
go back to reference Kennedy P, Evans MJ: Evaluation of post traumatic distress in the first 6 months following SCI. Spinal Cord. 2001, 39: 381-386. 10.1038/sj.sc.3101172.CrossRefPubMed Kennedy P, Evans MJ: Evaluation of post traumatic distress in the first 6 months following SCI. Spinal Cord. 2001, 39: 381-386. 10.1038/sj.sc.3101172.CrossRefPubMed
30.
go back to reference Woolrich RA, Kennedy P, Tasiemski T: A preliminary psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) in 963 people living with a spinal cord injury. Psychol Health Med. 2006, 11: 80-90. 10.1080/13548500500294211.CrossRefPubMed Woolrich RA, Kennedy P, Tasiemski T: A preliminary psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) in 963 people living with a spinal cord injury. Psychol Health Med. 2006, 11: 80-90. 10.1080/13548500500294211.CrossRefPubMed
31.
go back to reference Kennedy P, Evans M, Sandhu N: Psychological adjustment to spinal cord injury: the contribution of coping, hope and cognitive appraisals. Psychol Health Med. 2009, 14: 17-33. 10.1080/13548500802001801.CrossRefPubMed Kennedy P, Evans M, Sandhu N: Psychological adjustment to spinal cord injury: the contribution of coping, hope and cognitive appraisals. Psychol Health Med. 2009, 14: 17-33. 10.1080/13548500802001801.CrossRefPubMed
32.
go back to reference Migliorini C, Tonge B: Reflecting on subjective well-being and spinal cord injury. J Rehabil Med. 2009, 41: 445-450. 10.2340/16501977-0358.CrossRefPubMed Migliorini C, Tonge B: Reflecting on subjective well-being and spinal cord injury. J Rehabil Med. 2009, 41: 445-450. 10.2340/16501977-0358.CrossRefPubMed
33.
go back to reference Kennedy P, Lude P, Elfström ML, Smithson E: Cognitive appraisals, coping and quality of life outcomes: a multi-centre study of spinal cord injury rehabilitation. Spinal Cord. 2010, 48: 762-769. 10.1038/sc.2010.20.CrossRefPubMed Kennedy P, Lude P, Elfström ML, Smithson E: Cognitive appraisals, coping and quality of life outcomes: a multi-centre study of spinal cord injury rehabilitation. Spinal Cord. 2010, 48: 762-769. 10.1038/sc.2010.20.CrossRefPubMed
34.
go back to reference Rask KJ, Ziemer DC, Kohler SA, Hawley JN, Arinde FJ, Barnes CS: Patient activation is associated with healthy behaviors and ease in managing diabetes in an indigent population. Diabetes Educ. 2009, 35: 622-630. 10.1177/0145721709335004.CrossRefPubMed Rask KJ, Ziemer DC, Kohler SA, Hawley JN, Arinde FJ, Barnes CS: Patient activation is associated with healthy behaviors and ease in managing diabetes in an indigent population. Diabetes Educ. 2009, 35: 622-630. 10.1177/0145721709335004.CrossRefPubMed
35.
go back to reference Lannem AM, Sørensen M, Lidal IB, Hjeltnes N: Perceptions of exercise mastery in persons with complete and incomplete spinal cord injury. Spinal Cord. 2010, 48: 388-392. 10.1038/sc.2009.136.CrossRefPubMed Lannem AM, Sørensen M, Lidal IB, Hjeltnes N: Perceptions of exercise mastery in persons with complete and incomplete spinal cord injury. Spinal Cord. 2010, 48: 388-392. 10.1038/sc.2009.136.CrossRefPubMed
36.
go back to reference Kinder RA: Psychological hardiness in women with paraplegia. Rehabil Nurs. 2005, 30: 68-72. 10.1002/j.2048-7940.2005.tb00362.x.CrossRefPubMed Kinder RA: Psychological hardiness in women with paraplegia. Rehabil Nurs. 2005, 30: 68-72. 10.1002/j.2048-7940.2005.tb00362.x.CrossRefPubMed
37.
go back to reference Stuifbergen AK, Morris M, Jung JH, Pierini D, Morgan S: Benefits of wellness interventions for persons with chronic and disabling conditions: a review of the evidence. Disabil Health J. 2010, 3: 133-145. 10.1016/j.dhjo.2009.10.007.CrossRefPubMedPubMedCentral Stuifbergen AK, Morris M, Jung JH, Pierini D, Morgan S: Benefits of wellness interventions for persons with chronic and disabling conditions: a review of the evidence. Disabil Health J. 2010, 3: 133-145. 10.1016/j.dhjo.2009.10.007.CrossRefPubMedPubMedCentral
38.
go back to reference Fann JR, Bombardier CH, Richards JS, Tate DG, Wilson CS, Temkin N: Depression after spinal cord injury: comorbidities, mental health service use, and adequacy of treatment. Arch Phys Med Rehabil. 2011, 92: 352-360. 10.1016/j.apmr.2010.05.016.CrossRefPubMed Fann JR, Bombardier CH, Richards JS, Tate DG, Wilson CS, Temkin N: Depression after spinal cord injury: comorbidities, mental health service use, and adequacy of treatment. Arch Phys Med Rehabil. 2011, 92: 352-360. 10.1016/j.apmr.2010.05.016.CrossRefPubMed
39.
go back to reference Kennedy P, Duff J, Evans M, Beedie A: Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries. Br J Clin Psychol. 2003, 42: 41-52. 10.1348/014466503762842002.CrossRefPubMed Kennedy P, Duff J, Evans M, Beedie A: Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries. Br J Clin Psychol. 2003, 42: 41-52. 10.1348/014466503762842002.CrossRefPubMed
40.
go back to reference Owen N, Fotheringham M, Marcus B: Communication Technology and Health Behavior Change. Health Behavior and Health Education. Theory, Research, and Practice. Edited by: Glanz K, Rimer, Lewis F. 2002, Jossey-Bass, John Wiley & Sons, Inc, San Francisco, 510-529. 3 Owen N, Fotheringham M, Marcus B: Communication Technology and Health Behavior Change. Health Behavior and Health Education. Theory, Research, and Practice. Edited by: Glanz K, Rimer, Lewis F. 2002, Jossey-Bass, John Wiley & Sons, Inc, San Francisco, 510-529. 3
41.
go back to reference Lorig K, Ritter PL, Laurent DD, Plant K, Green M, Jernigan VBB, Case S: Online diabetes self-management: a randomized study. Diabetes Care. 2010, 33: 1275-1281. 10.2337/dc09-2153.CrossRefPubMedPubMedCentral Lorig K, Ritter PL, Laurent DD, Plant K, Green M, Jernigan VBB, Case S: Online diabetes self-management: a randomized study. Diabetes Care. 2010, 33: 1275-1281. 10.2337/dc09-2153.CrossRefPubMedPubMedCentral
42.
go back to reference Self-Management Support for Canadians With Chronic Health Conditions. 2012, Health Council of Canada, Toronto Self-Management Support for Canadians With Chronic Health Conditions. 2012, Health Council of Canada, Toronto
43.
go back to reference Ljungberg I, Kroll T, Libin A, Gordon S: Using peer mentoring for people with spinal cord injury to enhance self-efficacy beliefs and prevent medical complications. J Clin Nurs. 2011, 20: 351-358. 10.1111/j.1365-2702.2010.03432.x.CrossRefPubMed Ljungberg I, Kroll T, Libin A, Gordon S: Using peer mentoring for people with spinal cord injury to enhance self-efficacy beliefs and prevent medical complications. J Clin Nurs. 2011, 20: 351-358. 10.1111/j.1365-2702.2010.03432.x.CrossRefPubMed
44.
go back to reference Keller VF, White MK: Choices and challenges: a new model for influencing patient health behavior. J Clin Outcomes Manag. 1997, 4: 33-36. Keller VF, White MK: Choices and challenges: a new model for influencing patient health behavior. J Clin Outcomes Manag. 1997, 4: 33-36.
45.
go back to reference Levich BR: Self-Management in Chronic Illness. Chronic Disease Management. Edited by: Nuovo J. 2007, Springer Science + Business Media, LLC, New York Levich BR: Self-Management in Chronic Illness. Chronic Disease Management. Edited by: Nuovo J. 2007, Springer Science + Business Media, LLC, New York
46.
go back to reference Guilcher SJT, Munce SEP, Couris CM, Fung K, Craven BC, Verrier M, Jaglal SB: Health care utilization in non-traumatic and traumatic spinal cord injury: a population-based study. Spinal Cord. 2010, 48: 45-50. 10.1038/sc.2009.78.CrossRefPubMed Guilcher SJT, Munce SEP, Couris CM, Fung K, Craven BC, Verrier M, Jaglal SB: Health care utilization in non-traumatic and traumatic spinal cord injury: a population-based study. Spinal Cord. 2010, 48: 45-50. 10.1038/sc.2009.78.CrossRefPubMed
47.
go back to reference Ide-Okochi A, Tadaka E, Fujimura K: The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study. BMC Neurol. 2013, 13: 115-10.1186/1471-2377-13-115.CrossRefPubMedPubMedCentral Ide-Okochi A, Tadaka E, Fujimura K: The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study. BMC Neurol. 2013, 13: 115-10.1186/1471-2377-13-115.CrossRefPubMedPubMedCentral
Metadata
Title
Views of people with traumatic spinal cord injury about the components of self-management programs and program delivery: a Canadian pilot study
Authors
Sarah EP Munce
Michael G Fehlings
Sharon E Straus
Natalia Nugaeva
Eunice Jang
Fiona Webster
Susan B Jaglal
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2014
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-014-0209-9

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